There is life with HIV

Another part of the puzzle of the growing link between HIV and cardiovascular disease is unveiled!

Cardiovascular disease and TAE (epicardial adipose tissue) in seropositive patients

The heart is a large muscle that helps move blood around the body. Despite its important pumping action, the heart is not simply a muscle; about 20% of this body consists of a fatty layer called TAE (epicardial adipose tissue). This layer acts as a source of energy for the heart because it is high in saturated fat. Many fatty tissues can release hormones called adipokines that affect the health of the arteries and other parts of the cardiovascular system, and the researchers believe that the APR can produce such hormones.

Affecting heart health

In studies of HIV-negative patients, the researchers found evidence of inflammation in the TAE in patients with coronary artery disease. Moreover, these persons TAE containing immune cells such as macrophages and T cells in TAE obese people produces chemical signals that produce inflammation in other cells.

Researchers do not know precisely how the APR plays a role in heart disease, but they suspect that excess TAE can affect the functioning of the heart muscles eum increase in inflammation in the blood vessels of the heart.

TAE and other parts of the human body

The researchers made the following discoveries about APR.

The volume of TAE is related to the fat deposits in the abdomen bottom (visceral fat) and often settles around abdominal vital organs such as the liver ...

Excess TAE has been associated also to abnormal blood sugar levels and a decrease in tissue sensitivity to insulin, both diabetes precursors and thickening of the arteries.

The disruption of the heart's electrical activity have also been linked to excess TAE.

Given the interest the TAE and cardiovascular disease in HIV-negative patients, the researchers turned to the TAE study in HIV-positive patients.

With repeated CT scans high-resolution chest, a team of research in Modena, Italy, were measured TAE changes over a period of 18 months, more than 200 voluntary HIV positive patients were taking antiretroviral therapy (Therapy antiretroviral).

During the study, the researchers also measured the level of calcium that was deposited in the arteries. The calcium, which comes from dead cells and cell debris that accumulates along the vessels because of inflammation, form sticky deposits called "plates".

Italian researchers found that, overall, men tended to have larger increments TAE towards women. The increased volume of TAE was associated with increased calcium deposits in arteries. Researchers believe that part of the reason for the excess TAE and calcium deposits in some participants may be due to abnormal stimulation of the immune system by chronic HIV infection.

Study Details

Researchers recruited participants from January 240 2005 2011 and June. All were adults and antiretroviral therapy during the 18 previous months. None of them had a heart attack, stroke or peripheral vascular disease, and, moreover, none of them had undergone elective heart surgery or emergency.

Upon entering the study, the average "profile" of the participants were as follows:

  • 68% Of men, 32% of women
  • Age - 47 years
  • T lymphocyte count CD4 + <500 cells
  • Viral load below 40 copies / ml (undetectable)
  • 50% do not engage in physical exercise
  • 40% showed higher blood pressure than normal
  • The BMI (body mass index) and a relative evaluation of body fat were considered "within a range considered healthy *** ***".
  • Two scans were performed with an average of 18 months between them.

And from this information was obtained the SAR levels and calcium deposits in the arteries.

Results

Men generally have significantly larger amounts of TAE (88 mm3) than women (61 mm3). In addition, increased volume of TAE were literally connected to the male.

During the study, the proportion of subjects whose volume was increased TAE 64%. The TAE volume remained stable or declined among the other participants.

The increase of calcium deposits in the coronary arteries occurred between 10% of participants, most of which were men. Participants who had higher calcium deposits in coronary artery were more likely to have an increase of their volume TAE during the study.

The immune system and cardiovascular diseases

Infections with viruses and other microorganisms activate the immune system and release chemical signals that incite inflammation. This is a normal response and usually helps to alert the immune system cells to an infection. It also helps to alter the metabolism and affects the behavior of many organs and apparatus in a way that is useful in fighting infections, click here to know more. However, after the infection has been brought under control, the immune system is generally able to return to its normal state, as well as levels of immune and inflammatory activation. Because the immune system (and its cells) is distributed throughout the body, a constantly activated immune system affects the functioning of many other organs and systems, including the heart and blood vessels.

HIV infection causes immune system remains activated. This activation is greatly reduced when HIV-positive people on ART, but because the ART does not cure HIV infection, the immune system remains activated. Thus, studies have shown that people with HIV are at increased risk for cardiovascular disease. It is unclear exactly how HIV increases the risk for cardiovascular disease, but many teams are investigating possible reasons for this high risk.

In the analysis of their medical records and the extraction and data analysis, the Italian researchers found an association between increased CD4 + cells detected after participants began receiving ART (antiretroviral therapy) an increase in TAE volume. This does not mean that the increase of CD4 + cells caused the growth of Adipose Tissue epicardial. Instead, researchers suspect that some of CD4 + cells were activated and that these activated cells caused inflammation in TAE. Unfortunately, the research team did not conduct detailed immunological sub-studies needed to assess whether the CD4 + cells were actually activated.

The findings of Italy are one more piece of the puzzle of the growing link between HIV and cardiovascular disease. In addition, they emphasize the importance of investigating calcium deposits in the arteries and changes in the volume of epicardial adipose tissue.

Studies in HIV-negative patients and obese people have shown that significant changes in the diet may reduce the levels of APR.

Studies in seropositive patients are needed to find out whether decrease the volume of TAE can be done with diet, exercise and other attempts to reduce inflammation in the short term. Long-term monitoring is needed to assess whether interventions result in improved health among people with HIV.

Claudio Souza
This is responsible for the translation and adaptation to Portuguese of Brazil

Note the Seropositive Editor Web Site: Leaving aside the problems, the question of continuing the body's infection (remember a doctor who explained to me that my propensity to generation"Thrombus" and the consequent constant risk of pulmonary embolism (I had two in ten years) is due in part to a genetic condition, which he believes exist based on medical history and missing my mother (I do not see there at least 15 years ). The fact is that if you ever eaten chicken heart skewers, you have seen, even the TAE, Adipose Tissue epicardial, and you know what they are talking about (this "back fat" which is on top of the chicken little heart) ; however, adhere to the Wisdom and Goodness of God, the Supreme Intelligence, the Cause of Causes and it's just that I register my excitement brought about by the Mercy of Our Eternal Father ... Not far I want to catechize and evangelize, I do not profess any religion and dispense stone temples as _adoração of places to Deus_; My work is my prayer and, in the measure of Divine Justice, I can dare to say that now, after nearly fifteen years of dedication to this site, I am, as I said, with lower rate before my Heavenly Father. The more I read, translate and publish, the more I charm me with God and his inscrutable designs .... Nothing more to say!

Resources

CATIE's fact sheet on HIV and cardiovascular disease

-Sean R. Hosein

REFERENCES:

Iacobellis G and Bianco AC. Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features. Trends in Endocrinology and Metabolism. 2011; 22 (11): 450-457.
Nasir K, Rubin J, Blaha MJ, et al. Interplay of coronary artery calcification and traditional risk factors for the prediction of all-cause mortality in asymptomatic Individuals. Circulation: Cardiovascular Imaging. 2012; in press.
Zone S, P Raggi, Bagni P, et al. Parallel Increase of subclinical atherosclerosis and adipose tissue epidcardial in patients with HIV. American Heart Journal. 2012, 163: 1024-1030.
Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature. 2011, 473: 317-325.
Triant VA. HIV infection and coronary heart disease: an intersection of epidemics. Journal of Infectious Diseases. 2012, 205 (supplement 3): S3550-S361.
J Lo and Plutzky J. The biology of atherosclerosis: paradigms general and distinct pathogenic mechanisms Among HIV-infected patients. Journal of Infectious Diseases. 2012, 205 (supplement 3): S368-S374.
Hsue PY, Deeks SG and PW Hunt. Immunological basis of cardiovascular disease in HIV-infected adults. Journal of Infectious Diseases. 2012, 205 (supplement 3): S375-S382.

This information was provided by CATIE (Canada Exchange of AIDS treatment information). For more information, contact CATIE, 1.800.263.1638 or Catie. The credit must appear on any online publication, with a link back to the original.

The translation into Portuguese of Brazil can be used without prior authorization and, however, is the person or institution that makes use of this version a requirement for all claims, including all underlined text.

Translation adjustment and revision of the original in English Canada for the Portuguese of Brazil (it does not exist Brazil with "z" and "Brazil" is an idiomatic aberration created for persons Which only God knows why They do this ...) the original Cardiovascular disease and EAT in HIV-positive people by Claudio Souza.

If you have good knowledge of the English language and have time to assess my translation and send your comments to this address E-mail

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